Provider Demographics
NPI:1093113458
Name:KARBOUSKI, KENDRA (LCSW)
Entity type:Individual
Prefix:
First Name:KENDRA
Middle Name:
Last Name:KARBOUSKI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KENDRA
Other - Middle Name:
Other - Last Name:BECHTOL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APSW
Mailing Address - Street 1:2010 MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53546-3802
Mailing Address - Country:US
Mailing Address - Phone:608-774-3333
Mailing Address - Fax:
Practice Address - Street 1:2010 MEADOW LN
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53546-3802
Practice Address - Country:US
Practice Address - Phone:608-774-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-16
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI129598104100000X
WI8738-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker